They’re uncomfortable, gross and almost inevitable for those who ride a bike. Saddle sores, or painful lesions on the buttocks, groin, perineum, or upper thighs, have plagued many a triathlete. Though most cases are benign and disappear quickly, saddle sores can and do progress to abscesses requiring prescription drugs and/or surgery.
Anatomy of a Saddle Sore
“Saddle sores develop when an abrasion or hair follicle becomes inflamed or infected by bacteria,” says Dr. Cynthia Bartus, a dermatologist and triathlete from Allentown, Penn. “Cyclists are prone to saddle sores because they are at higher risk for developing abrasions due to the friction created between the body and the saddle.”
That friction, combined with a sweaty, warm environment, is a breeding ground for bacteria. Intact skin will not become infected with the bacteria, but any break in the skin barrier or trauma to a hair follicle (such as shaving) gives bacteria an opportunity to start multiplying, resulting in the saddle sore.
Saddle sores present themselves in a variety of forms, from simple abrasions resembling rug burn, to pimples, to an abscess.
Saddle sores don’t favor a particular gender—both males and female cyclists are prone to them. However, people who are more prone to infections due to a weakened immune system, those with medical conditions such as diabetes, and the overweight may be more susceptible to saddle sores.
According to Bartus, most saddle sores should resolve within a few days (a week at the most). If a saddle sore is not improving after a few days, or if a sore becomes extremely painful, Bartus recommends contacting a doctor.
Healing can be expedited by applying an over-the-counter acne cream with benzoyl peroxide or salicylic acid, and soaking the area with a warm compress. It is also best to temporarily remove the two factors contributing to saddle sores—sweat and friction—by staying off the bike until the condition resolves.
If the sore is worsening, a physician may recommend a prescription-strength antibiotic or anti-acne cream. For severe sores, a course of oral antibiotics or even surgical drainage may be necessary.
Though saddle sores are a fact of life for most triathletes, many steps can be taken to reduce their incidence and severity. Bartus suggests a two-pronged plan to keep saddle sores at bay:
1. Reduce friction
a. Lubricate using commercial chamois cream products, diaper creams, petrolatum (Vaseline).
b. Ride a properly fitting saddle on a properly fitting bike.
c. Wear cycling or triathlon shorts with a chamois liner and smooth seams.
d. Stand or change position frequently to relieve any “hot spots” that develop.
2. Keep clean and as dry as possible
a. Wear clean shorts with a moisture wicking chamois for each ride.
b. Remove shorts as soon as possible after riding.
c. Wash with warm, soapy water as soon as possible.
d. When not on the bike, wear loose-fitting undergarments and clothing that allows the skin to breathe.
e. Sleep without underwear.
For those prone to frequent saddle sores, washing with an antibacterial soap or cleanser a few times a week can help reduce the bacterial load. Bartus also suggests washing towels, washcloths, and underwear in hot water to reduce bacteria that may come in contact with the skin.